| NPI | 1174929509 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTINA HALL Clinic Director 505-200-2306 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0401X Clinic/Center, Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF) (Licence: NM DC1936) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: NM DC1936) |
| 111NR0400X Chiropractor, Rehabilitation (Licence: NM DC1936) | |
| 261QP2000X Clinic/Center, Physical Therapy (Licence: NM DC1936) | |
| Enumeration Date | 2014-11-12 |
| Last Update Date | 2014-11-12 |